中国慢性乙型肝炎患者接受聚乙二醇干扰素α治疗的甲状腺

StephenW

中国慢性乙型肝炎患者接受聚乙二醇干扰素α治疗的甲状腺功能障碍发生率及危险因素：一项长期随访研究
马振轩 1 2 , 秦艳丽 1 , 贾一迪 1 , 谢怡然 1 , 齐勋 1 , 郭逸飞 1 , 何晶晶 1 , 张永梅 1 , 李发红 1 , 于洁 1 , 朱浩祥 1 , 杨飞飞 1 , 于张 2 , 毛日成 1 , 张继明 1
隶属关系
隶属关系

    1
    【作者单位】： 复旦大学华山医院感染科;
    2
    【作者单位】： 复旦大学华山医院老年病科;

    PMID：35293082 DOI：10.1111/jvh.13667

抽象的

接受聚乙二醇干扰素 (IFN) α (PegIFN-α) 治疗的慢性乙型肝炎 (CHB) 患者甲状腺功能障碍的长期影响、发病率和危险因素仍不清楚。我们旨在调查接受 PegIFN-α 的慢性乙型肝炎患者甲状腺功能障碍的长期安全性。对 425 名基线甲状腺功能正常的慢性乙型肝炎患者进行了一项回顾性观察研究。接受 IFN 后对患者进行 10 年以上的随访以评估甲状腺功能。在干扰素治疗结束时，67 例（15.8%）患者出现甲状腺功能障碍，31 例患者（46.3%）出现甲状腺功能亢进，64.4% 出现亚临床甲状腺功能障碍。甲状腺功能障碍患者随访中，37例（74.0%）甲状腺功能自发恢复正常。治疗前促甲状腺激素（TSH）水平、甲状腺过氧化物酶抗体（TPOAb）阳性和游离甲状腺素（FT4）是与甲状腺功能障碍发生率相关的独立危险因素。高 TSH 水平 (OR=9.866, 95%CI, 3.245-29.998) 与甲状腺功能减退的可能性更大有关。高 FT4 水平 (OR=0.464, 95%CI, 0.248-0.868) 表明甲状腺功能障碍的可能性较低。甲状腺功能障碍是 IFN 治疗慢性乙型肝炎常见但可接受的副作用。大多数甲状腺功能障碍是可逆的。治疗前 TSH 水平和 TPOAb 阳性是 IFN 治疗期间甲状腺功能障碍发展的危险因素。高 TSH 水平预示着甲状腺功能减退症的发病率增加。此外，FT4可能是甲状腺功能障碍的保护因素。

关键词：慢性乙型肝炎；长期随访；聚乙二醇化干扰素α；甲状腺功能减退。

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StephenW

Thyroid dysfunction incidence and risk factors in Chinese chronic hepatitis B patients treated with pegylated interferon alpha: a long-term follow-up study
Zhenxuan Ma  1   2 , Yanli Qin  1 , Yidi Jia  1 , Xie Yiran  1 , Qi Xun  1 , Yifei Guo  1 , Jingjing He  1 , Yongmei Zhang  1 , Fahong Li  1 , Jie Yu  1 , Haoxiang Zhu  1 , Feifei Yang  1 , Yu Zhang  2 , Richeng Mao  1 , Jiming Zhang  1
Affiliations
Affiliations

    1
    Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
    2
    Department of Geriatrics, Huashan Hospital, Fudan University, Shanghai, China.

    PMID: 35293082 DOI: 10.1111/jvh.13667

Abstract

The long-term impact, incidence, and risk factors of thyroid dysfunction in chronic hepatitis B (CHB) patients receiving pegylated interferon (IFN) alpha (PegIFN-alpha) therapy remain unclear. We aim to investigate the long-term safety of thyroid dysfunction in CHB patients receiving PegIFN-alpha. A retrospective observational study of 425 CHB patients with normal baseline thyroid function was carried out. Patients were followed up over 10 years to assess thyroid function after receiving IFN. At the end of the IFN therapy, 67 patients (15.8%) had developed thyroid dysfunction, 31 patients (46.3%) had hyperthyroidism, and 64.4% presented with subclinical thyroid dysfunction. In follow-up of thyroid dysfunction patients, 37 patients (74.0%) spontaneously regained normal thyroid function. Pretreatment thyroid stimulating hormone (TSH) level, thyroidperoxidase antibody (TPOAb) positivity, and free thyroxine (FT4) were independent risk factors associated with thyroid dysfunction incidence. High TSH level (OR=9.866, 95%CI, 3.245-29.998) was associated with a greater likelihood of hypothyroidism. High FT4 levels (OR=0.464, 95%CI, 0.248-0.868) indicate a low likelihood of thyroid dysfunction. thyroid dysfunction is a common but acceptable side effect of IFN therapy for CHB. Most thyroid dysfunction is reversible. Pretreatment TSH level and TPOAb positivity are risk factors for thyroid dysfunction development during IFN therapy. A high TSH level predicts an increased incidence of hypothyroidism. Moreover, FT4 may be a protective factor for thyroid dysfunction.

Keywords: chronic hepatitis B; long-term follow-up; pegylated interferon alpha; thyroid dysfunction.

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newchinabok

甲状腺不良反应严重就停干挠素，恢复就再干挠，打打停停，停停打打。干挠素是就瞎胡闹的药，就瞎胡闹的治。目前又没好办法，乙肝是不治之症